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Tingginya Angka Kematian Ibu (AKI) menjadi salah satu isu prioritas kesehatan di Indonesia. Penggunaan kontrasepsi modern pascasalin merupakan strategi efektif untuk menekan AKI dengan mengatur jarak kehamilan. Namun, cakupannya belum merata, dengan disparitas signifikan antarprovinsi. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan penggunaan kontrasepsi modern pascasalin di Provinsi Jawa Timur dan Sumatera Utara.
Penelitian ini menggunakan desain potong lintang (cross-sectional) dengan analisis data sekunder dari Survei Kesehatan Indonesia (SKI) 2023. Sampel terdiri dari wanita usia subur (15-49 tahun) yang telah melahirkan. Analisis data dilakukan menggunakan regresi logistik multivariabel. Hasil penelitian menunjukkan proporsi penggunaan kontrasepsi modern pascasalin di Jawa Timur (79,2%) lebih tinggi secara signifikan dibandingkan Sumatera Utara (50,5%). Faktor determinan di Sumatera Utara adalah umur, status pekerjaan, dan konseling KB. Di Jawa Timur, faktor yang berhubungan adalah daerah tempat tinggal, status ekonomi, paritas, dan konseling KB. Konseling KB pascasalin menjadi satu-satunya faktor yang berhubungan signifikan di kedua provinsi. Kesimpulannya, terdapat perbedaan determinan dalam penggunaan kontrasepsi modern pascasalin antara kedua provinsi, yang menyoroti pentingnya intervensi spesifik sesuai konteks wilayah. Penguatan layanan konseling menjadi kunci strategis untuk meningkatkan cakupan secara nasional.
The high Maternal Mortality Rate (MMR) is a priority health issue in Indonesia. The use of modern postpartum contraception is an effective strategy to reduce MMR by managing pregnancy spacing. However, its coverage is uneven, with significant disparities between provinces. This study aims to analyze the factors associated with the use of modern postpartum contraception in East Java and North Sumatra provinces. This study employed a cross-sectional design using secondary data analysis from the 2023 Indonesian Health Survey (SKI). The sample consisted of women of childbearing age (15-49 years) who had previously given birth. Data were analyzed using multivariate logistic regression. The results showed that the proportion of modern postpartum contraceptive use in East Java (79.2%) was significantly higher than in North Sumatra (50.5%). The determining factors in North Sumatra were age, employment status, and family planning counseling. In East Java, the associated factors were area of residence, economic status, parity, and family planning counseling. Counseling was the only factor significantly associated in both provinces. In conclusion, there are different determinants for the use of modern postpartum contraception between the two provinces, highlighting the importance of region-specific interventions. Strengthening counseling services is a strategic key to increasing coverage nationally.
A good understanding of the role of men in the formation of an ideal family and reproductive health planning can have a good impact in a family planning program. This study seeks to the predictors of modern contraceptive use and fertility preference among sexually active men in Indonesia. The data source is the nationally representative 2017 Indonesia Demographic and Health Survey (IDHS) of men aged 15-54 years. The analysis is restricted to 9,277 men who reported being sexually active in the past 12 months prior to the survey, have a married status, and living with his wife. This research use bivariate and multinominal logistic regression to access predictors that influence modern contraceptive use and fertility preference among sexually active men. Bivariate and multivariable multinomial logistic regression analysis was conducted and statistical significance was set at p-value<0.05. From a total of 9,277 sexually active men in Indonesia, 309 (3,3%) used male modern contraception methods and 8,968 (96,7%) didn't use modern contraception. Besides that, from the total sample, 4,383 (47,2%) is the fertility preference of male that didn't want another child and 4,894 (52,8%) men indecisive or still want another child. Findings from the bivariate and multinominal logistic regression indicate that education (OR=3,02; 95% CI: 1,72-5,31 ), residence (OR=1,75; 95% CI: 1,18-2,58), wealth index(OR=3,57; 95% CI: 1,87-9,50), currently working (OR=13,32; 95% CI: 1,83-96,76), living children (OR=2,1; 95% CI: 1,35-3,24), istri menggunakan KB (OR=0,07; 95% CI: 0,05-0,11), access to media (OR=1,83; 95% CI: 1,23-2,72), disscuss with health worker (OR=0,47 ; 95% CI: 0,30-0,72), disscuss with wife (OR=2,71; 95% CI: 1,94-3,79), knowledge (OR=1,69; 95% CI: 1,23-2,32), dan fertility preference (OR=1,72; 95% CI: 1,22-2,43) were all significantly associated with modern contraceptive use among sexually active men. Other result finding that age (OR=4,55; 95% CI: 3,87-5,34), education level (OR=0,77; 95% CI: 0,67-0,89), residence (OR=1,26; 95% CI: 1,10-1,45), living children (OR=13,2; 95% CI: 10,45-16,68), wife using contraceptive (OR=1,32; 95% CI: 1,15-1,51), access to media (OR=0,83; 95% CI: 0,72-0,96), disscuss with wife (OR=0,86; 95% CI: 0,75-0,98), and knowledge (OR = 1,28; 95% CI: 1,11-1,48) were all significantly assosiated with fertility preference in a men who didn't want another child. These findings suggest that future policies and programs should focus on interventions and promoting men's contraception in media, addressing regional disparities in accessibility and availability of modern contraceptive, and interventions family planning in the middle of level education.
Pneumonia is the leading causes of death among children under five in Indonesia. Exclusive breastfeeding and vitamin A supplementation are recommended strategies for preventing pneumonia. Although the coverage of both has reached national targets, the prevalence of pneumonia increased from 4.8% in 2018 to 15% in 2023. This study aimed to examine the association between exclusive breastfeeding and vitamin A supplementation with the incidence of pneumonia among children aged 12–23 months in Indonesia. This study used a cross-sectional design based on data from 2023 SKI. Data analysis was conducted using univariate, bivariate, and multivariate methods. The results showed no statistically significant association between exclusive breastfeeding and vitamin A supplementation with pneumonia incidence. However, after considering interaction variables and controlling for confounding variables (child’s sex, history of diarrhea, and drinking water source), an increased risk of pneumonia was found among children who were not exclusively breastfed (AOR: 1.466; 95% CI: 0.928–2.315), although the association was not statistically significant. Meanwhile, the association between vitamin A supplementation and pneumonia became statistically significant (AOR: 3.029; 95% CI: 1.339–6.852). Therefore, strengthening educational programs through community empowerment is needed as a promotive-preventive strategy to improve exclusive breastfeeding and vitamin A practices in efforts to prevent pneumonia in children.
Treatment adherence for tuberculosis (TB) remains one of the major health challenges in TB control efforts in Indonesia. The proportion of TB patients adhering to treatment decreased from 69.2% in 2018 to 62.5% in 2023. In the DOTS strategy, one of the key efforts to improve treatment adherence is the presence of a Treatment Supervisor (Pengawas Menelan Obat or PMO). However, the proportion of TB patients with a PMO also declined from 66.2% to 62.1%. This study aims to examine whether the decline in PMO presence contributed to the decrease in treatment adherence among TB patients aged ≥15 years in Indonesia, using secondary data from the 2023 Indonesia Health Survey (Survei Kesehatan Indonesia or SKI). The study design is cross-sectional, and analyses were conducted using univariate, bivariate, and multivariate methods. The results showed a significant association between the presence of a PMO and treatment adherence (OR: 4.62; 95% CI: 2.39–8.93). After controlling for age, sex, education level, economic status, comorbid diabetes mellitus, and health insurance ownership, the presence of a PMO remained positively associated with adherence (AOR: 4.41; 95% CI: 2.18–8.90). These findings indicate that the presence of a PMO is relevant and essential for improving TB treatment adherence and success in Indonesia. The efforts to enhance patient adherence should also focus on optimizing the role and quality of PMO, whether from family members or healthcare providers.
Latar Belakang: KB memiliki sejarah keberhasilan dalam meningkatkan pemakaian kontrasepsi modern dalam waktu relatif pendek, yaitu dari 10% di awal dekade 1970-an menjadi sekitar 60% di awal 2000-an. Namun, pada kurun waktu tersebut hingga 2017 terjadi pergeseran dominasi metode kontrasepsi yang digunakan oleh perempuan usia subur berstatus kawin, yaitu dari penggunaan metode kontrasepsi yang beragam menjadi dominasi Non MKJP, khususnya suntik KB.
Metode: Analisis data sekunder dilakukan dengan menggunakan data SKI tahun 2023. Uji chi-square dan regresi logistik dengan interval kepercayaan 95% digunakan dalam penelitian ini untuk menggambarkan kekuatan hubungan antar variabel.
Hasil: Cakupan penggunaan MKJP pada perempuan usia subur berstatus kawin di Indonesia dalam penelitian ini mencapai 28,8%. Hasil analisis multivariabel menunjukkan bahwa variabel yang memiliki hubungan secara statistik antara lain adalah usia, pendidikan responden, status pekerjaan responden, paritas, status ekonomi, wilayah administratif, pendidikan pasangan, dan konseling KB.
Kesimpulan: Semakin tingginya tingkat pendidikan yang ditempuh oleh seorang perempuan, semakin tinggi juga peluang yang dimilikinya untuk menggunakan MKJP. Hal ini disebabkan karena dengan tingkat pendidikan tersebut perempuan akan cenderung lebih mudah memahami informasi dan manfaat MKJP, serta memiliki kapasitas lebih besar dalam pengambilan keputusan terkait kontrasepsi. Oleh karenanya, peningkatan akses dan kualitas informasi dapat menjadi salah satu strategi yang dapat mendorong penggunaan MKJP secara lebih luas.a
Background: The family planning program has a history of success in increasing the use of modern contraceptives within a relatively short period, rising from 10% in the early 1970s to around 60% in the early 2000s. However, during that period up to 2017, there was a shift in the dominant contraceptive methods used by women of reproductive age—from a variety of methods to a dominance of non-long-acting and permanent methods (non-LARCs), particularly injectable contraceptives. Method: The proportion of long-acting reversible contraceptive (LARC) use among women of reproductive age in Indonesia in this study reached 28.8%. The multivariable analysis showed that several variables were statistically associated with LARC use, including age, respondent’s education, respondent’s employment status, parity, economic status, administrative region, partner’s education, and FP counseling. Results: Women with a secondary education level are more likely to use long-acting reversible contraceptive (LARCs). This is because, at this level of education, women tend to better understand information regarding the benefits of LARCs and have greater capacity in making decisions related to contraception. Therefore, improving access to and the quality of information may serve as an effective strategy to promote broader use of LARCs. Conclusion: The higher the level of education attained by a woman, the greater her likelihood of using long-acting reversible contraceptive (LARCs). This is because women at this education level tend to understand information about the benefits of LARCs more easily and have greater capacity in making decisions related to contraception. Therefore, improving access to and the quality of information can be an effective strategy to encourage wider use of LARCs.
The prevalence of anemia in pregnant women should decrease, considering the number in Indonesia has included a severe public health problem (43.2%). The cause of anemia in pregnant women is greater due to iron deficiency. Therefore, it is necessary to take iron supplementation or blood-added tablets for pregnant women to prevent the risks posed by iron deficiency anemia in pregnant women. Based on the 2017 IDHS report, it is known that the consumption of blood-added tablets according to the health recommendations of pregnant women is only 44% and this figure is still far from the 2015-2019 Strategic Plan target. This study aims to determine the factors associated with the consumption of blood-added tablets in pregnant women in Indonesia. This study is a quantitative study with a cross-sectional research design and the use of data from the 2017 Indonesian Health Demographic Survey. The analysis in this study was carried out using descriptive statistics, chi-square test and multiple logistic regression. The results showed that the proportion of pregnant women who consumed at least 90 tablets added blood was 44.1% (42.8% -45.4%). There is a significant relationship between the consumption of blood-added tablets with wealth index, area of residence, marital status, frequency of ANC visits, time of first ANC, parity, and husband's support. The most dominant factor related to the consumption of blood-added tablets is the frequency of ANC visits. Therefore, health care workers need to provide education to pregnant women to do ANC as often as possible which is part of the program of giving blood-added tablets to control their health during pregnancy to prevent the risk of iron deficiency.
Berat badan lahir rendah berkontribusi terhadap morbiditas dan mortalitas neonatal, menjadikannya indikator penting kesehatan ibu dan anak. Data Riskesdas 2018 dan SKI 2023 menunjukkan prevalensi BBLR di Indonesia belum mengalami penurunan signifikan, dengan variasi antarwilayah, sehingga perlu penelitian tentang determinan BBLR berdasarkan regional. Penelitian ini menggunakan desain cross-sectional dengan data sekunder SKI 2023, dianalisis berdasarkan lima regional Indonesia menggunakan uji chi-square dan regresi logistik. Hasil menunjukkan variasi proporsi BBLR antarregional, dengan Sulawesi tertinggi dan Sumatera terendah. Di Sumatera, faktor terkait BBLR adalah anemia, plasenta previa, kehamilan kembar, kelahiran prematur, dan interaksi kehamilan kembar dengan komplikasi. Di Jawa-Bali, faktor yang berhubungan adalah paritas, komplikasi kehamilan, kehamilan kembar, jenis kelamin, kelahiran prematur, dan kelahiran prematur yang berinteraksi dengan kehamilan kembar. Di Kalimantan, faktor terkait adalah usia ibu, paritas, komplikasi, serta interaksi kehamilan kembar dengan jenis kelamin dan kelahiran prematur. Di Sulawesi, faktor yang berhubungan adalah status ekonomi, pendidikan ibu, paritas, konsumsi tablet tambah darah, komplikasi, plasenta previa, kehamilan kembar, jenis kelamin, dan kelahiran prematur. Di Papua, Maluku, Nusa Tenggara, faktor terkait adalah status ekonomi, paritas, komplikasi, dan interaksi kehamilan kembar dengan kelahiran prematur. Diperlukan intervensi berbasis wilayah untuk meningkatkan pelayanan kesehatan ibu hamil, terutama di Sulawesi, dengan fokus pada faktor risiko utama seperti kehamilan kembar, kelahiran prematur, dan anemia.
Low Birth Weight (LBW) contributes to neonatal morbidity and mortality, making it an important indicator of maternal and child health. The 2018 Riskesdas data and the 2023 SKI reveal that the LBW prevalence in Indonesia has not significantly decreased, with regional variations, indicating the need for research on the regional determinants of LBW. This cross-sectional study uses secondary data from SKI 2023, analyzed across five regions in Indonesia using chi-square tests and logistic regression. The results show regional variations in LBW proportions, with Sulawesi having the highest and Sumatra the lowest prevalence. In Sumatra, factors associated with LBW include anemia, placenta previa, multiple pregnancies, prematurity, and interactions between multiple pregnancies and complications. In Java-Bali, factors associated with LBW include parity, pregnancy complications, multiple pregnancies, gender, prematurity, and the interaction between prematurity and multiple pregnancies. Kalimantan's related factors are maternal age, parity, complications, and interactions between multiple pregnancies, gender, and prematurity. In Sulawesi, factors related to LBW include maternal socioeconomic status, education, parity, iron supplement consumption, complications, placenta previa, multiple pregnancies, gender, and prematurity. Papua, Maluku, and Nusa Tenggara show associations with socioeconomic status, parity, complications, and interactions between multiple pregnancies and prematurity. Regional-based interventions are needed to improve maternal health services, especially in Sulawesi, with a focus on key risk factors such as multiple pregnancies, prematurity, and anemia.
